title: The outcome and efficacy of recanalization in patients with acute internal carotid artery occlusion.
abstract: OBJECTIVE
  Acute occlusion of the ICA is often associated with poor outcomes and severe neurologic deficits. This study was conducted to evaluate outcome of the occluded ICA and efficacy of recanalization under protective flow arrest.
  
  
  METHODS
  Fifty consecutive patients who underwent endovascular treatment for acute ICA occlusion were identified from the prospectively collected data base. We assessed NIHSSo, occlusion type (cardioembolism vs atherosclerosis), occlusion level (supraclinoid-terminal, petrocavernous, or bulb-cervical), recanalization degree (TICI), and efficacy of recanalization (protective flow arrest vs nonprotection) leading to better outcome.
  
  
  RESULTS
  Successful recanalization (TICI ≥ 2) was obtained in 90% of patients and good recovery (mRS ≤ 2) in 60% of patients. Good outcome was related to National Institutes of Health Stroke Scale score on admission (P < .001), TICI (P < .007), occlusion type (P = .022), and occlusion level (P = .038). Poor initial patient status, less recanalization, cardioembolism, and supraclinoid-terminal occlusion were associated with poor prognosis. Application of protective flow arrest led to better outcome in the distal ICA segment than in the bulb-cervical segment.
  
  
  CONCLUSIONS
  In addition to the initial patient status and successful recanalization, the occlusion level or type of the occluded ICA could affect clinical outcome. In this study, treatment benefits of protective flow arrest were accentuated in patients with ICA occlusion above the bulb-cervical segment.
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (J.H.K., L.Z., S.P., D.-g.L., J.H.S., D.H.L., D.C.S.).
authors.forename: J H
authors.initials: JH
authors.lastname: Kwak
authors.forename: L
authors.initials: L
authors.lastname: Zhao
authors.forename: J K
authors.initials: JK
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Park
authors.forename: D-G
authors.initials: DG
authors.lastname: Lee
authors.forename: J H
authors.initials: JH
authors.lastname: Shim
authors.forename: D H
authors.initials: DH
authors.lastname: Lee
authors.forename: J S
authors.initials: JS
authors.lastname: Kim
authors.forename: D C
authors.initials: DC
authors.lastname: Suh
mesh_terms: D000208:Acute Disease; D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000379:methods*; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017131:Thrombectomy; D016896:Treatment Outcome